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Rabies encephalitis mimicking the electrophysiological pattern of brain death. A case report
P Hantson1, J M Guérit, M de Tourtchaninoff
1Department of Intensive Care, St. Luc University Clinics, Brussels, Belgium.
European Neurology
|January 1, 1993
Summary
Rabies encephalitis is a fatal neurological disease. Multimodality evoked potentials, MRI, and autopsy definitively ruled out brain death, despite clinical signs suggesting it.
Area of Science:
- Neurology
- Infectious Diseases
- Neurophysiology
Background:
- Rabies encephalitis is a rare but fatal viral infection of the central nervous system.
- Early diagnosis and management are crucial, though often challenging.
- This case highlights diagnostic difficulties in advanced stages of rabies.
Observation:
- A 48-year-old woman presented with suspected rabies encephalitis.
- Clinical presentation and electroencephalography (EEG) suggested brain death.
- Neurophysiological and radiological investigations were performed serially.
Findings:
- Diagnosis of rabies was confirmed post-mortem via brain autopsy.
- Multimodality evoked potentials (MEPs) and magnetic resonance imaging (MRI) were critical in excluding brain death.
- EEG findings were consistent with brain death, but MEPs and MRI provided definitive exclusion.
Implications:
- Multimodality evoked potentials are valuable in diagnosing neurological conditions, especially when clinical signs are equivocal.
- Advanced neuroimaging and neurophysiological techniques can differentiate rabies encephalitis from brain death.
- This case underscores the importance of comprehensive diagnostic tools in managing rare and severe neurological infections.